Under The Knife: Playoff drive may put futures of many hurlers at risk

I won't step too far into Tom Verducci's territory, but while everyone's wringing their hands about Stephen Strasburg, a number of other pitchers are extending themselves beyond previous workload peaks and are headed toward the playoffs, which could extend them even further.

Recall Jaret Wright, who, even more than Mark Prior, is the example of how the playoffs can shred an arm. The momentum to push a pitcher is great, since "flags fly forever" and some saying "he can rest in the offseason." That's fine for someone with a mature arm, but not for younger pitchers. Not so much.

In compiling a list of pitchers who fall under Verducci Effect candidates, I used the Verducci guidelines -- 30 innings or more over the previous max, including minor league innings, and age-35 or younger -- to simplify things. The list actually goes 27 deep, in large part because so many teams are still "in it." I'm less concerned about relievers like Addison Reed, Robbie Ross or Jake McGee. Statistical flukes like Yu Darvish are their own case. That leaves us with several that need special attention:

* A's starters: The A's have four guys who meet the conditions, plus Brett Anderson, who is just back from Tommy John rehab. Jarrod Parker, A.J. Griffin, Tommy Milone, and Tyson Ross are all on this list. The first two could be in a playoff rotation.

* Rays starters: The Rays may have an amazing record of pitcher health, but having Alex Cobb and Matt Moore extended into the playoffs could really test them.

* Cardinals starters: The Cards pushed Lance Lynn to the pen to hold his innings down, but he and Joe Kelly are well into the danger zone.

* Chris Sale: Sale has already had arm problems this season, has questionable mechanics and now a workload issue.

How these pitchers are handled could have huge implications, especially since two of these franchises are known for small payrolls. The reliance on young pitching can go sideways quickly, as the A's showed in 2011, but there's upside as well. Whether that upside potential can be managed to minimize the downside risk could end up deciding not just this playoff race, but the next couple seasons as well.

Powered by the new Brother Ali album, on to the injuries:

The Tigers are fighting for a playoff spot, and losing Scherzer, who's been as good or better than any pitcher in the game over the second half, could be devastating. Scherzer lasted only two innings and had nothing in his latest start. His velocity dipped from 94 in the first inning, going down about 1 mph per batter. There was a jump up in the second inning, but it quickly fell and Scherzer was pulled. The velocity jump is worrisome, as that's usually a sign a pitcher realizes he's off, so he reaches back for a bit more. If this is nothing more than fatigue, the Tigers are lucky, but this feels like more. Monitor this closely over the next few days, but fantasy teams, like the Tigers, will be hard-pressed to replace Scherzer if he's out even a short time. A quick MRI showed no structural damage, which is good news, but still gives no guidance as to when or if Scherzer will be back, or how he'll pitch when he does.

The Dodgers reported that Kershaw has an impingement in his hip and not a torn labrum. As with the shoulder, impingement can mean a lot of things, few of them good. The diagnosis doesn't tell us whether Kershaw will eventually need surgery on his hip. We don't know yet whether waiting is significant for recovery time. We don't know yet if Kershaw can pitch this year without causing more damage. We don't know yet if Kershaw can pitch without altering his mechanics, risking that priceless arm. There's no way to tell what a proximate cause might be, leaving it to the medical and coaching staffs to make an educated guess. That's risky. This would be a perfect time to get a biomechanical work-up on him, to see if his arm is getting more stress during his delivery. The next few days will tell the tale, but the race for the Wild Card is close enough that this injury alone might tip the balance.

The influence of Chipper Jones is unquestionable. For the most part, Jones' presence has been a positive and one of the intangibles to consider for his Hall of Fame case. On the other hand, Jones' insistence on pushing his way back into the lineup from injury, bullying other players to do the same and ignoring the downsides of rushing back from injury has to factor in as well. It's the effect on players around him that's been most worrisome, costing some players significant time and keeping others from seeking out medical help early, which sometimes have made matters worse. It's impossible to know if that's the case with McCann, who was back in the Braves lineup on Tuesday.

Stanton has a mild oblique strain and the Marlins are being a bit cautious. Stanton's been known to exacerbate his injuries and has a difficult time moderating his workouts and activities. A couple days is nothing to the Marlins at this stage of the season, so don't be surprised if this one extends a little bit.

The Nats won't have Espinosa for the rest of the week ... probably. Espinosa injured his shoulder on a dive, much the same way that Adrian Beltre did. In much the same way, the injury is really more about what's going on inside. "Bruised" is an accurate description, but there's sure to be some microtrauma internally depending on how the shoulder moved inside the joint. There are some rumblings that Espinosa is pushing to come back early, but the Nats can be conservative given their division lead. This is the reverse of a situation going on in Missouri, where a college quarterback, James Franklin, passed on a painkiller injection and sat out a game. His coach questioned the decision, raising the possibility of possible HIPAA violations. Injections are no longer a matter of course, whether cortisone or otherwise, which is a good thing.

Lewis re-signed with the Rangers at a low base salary and a lot of incentives as he rehabs from elbow surgery. He should be back at some point next season, and depending on when that is and how he does, it could mean a solid payday. The contract also assures Lewis that he'll be able to have continuity in his rehab, sticking with the team and staff he knows and who know him. There's a value to Lewis, but there's also a value to the Rangers. They get "doing the right thing" points, something free agents notice and value when all things are equal.

Running into Prince Fielder isn't something I recommend. It seemed like Avila had escaped the worst of it, coming out with nothing more than a sore jaw. On Monday, Avila had a headache, which isn't necessarily a concussion symptom, but given the proximity to the event, the Tigers are playing it safe. They'll continue to monitor Avila, though it's unclear if he is still subject to the concussion protocols after having already passed them once. The assumption is that he could be back quickly, but concussions are unpredictable enough that I'm hanging a "TBD" up there.

Nice to see the big names getting on board with protective gear for pitchers ... The Yankees think they'll get Mark Teixeira back late next week. That will give him a few games to tune up his swing ... Aroldis Chapman is scheduled to throw a side session on Wednesday. The results will give the Reds a timeline on when he'll return to the pen ... Corey Hart remains day-to-day with his sore foot. The Brewers medical staff will do everything they can as long as the Brewers continue their surge ... The O's aren't sure if they'll get Jason Hammel back this season, but he's rehabbing with that hope in mind ... Catcher Carlos Gonzalez was a late scratch with a "tight" hamstring. The Rockies will be conservative here, so check him in daily leagues ... The Mets will resist the urge to accelerate R.A. Dickey's starts to give him more chances at 20 wins. It'd be an interesting and valuable experiment, however, assuming Dickey is relatively healthy and not over-fatigued at this stage of a long season ... Cameron Maybin is dealing with an Achilles injury. That's a tough one for a speed guy, so note this and watch to see that it's cleared up next spring ... Jim Thome could be back with the O's this weekend. Buck Showalter will find a way to use anything he can get at this stage ... Chris Young left with a strained quad, a recurrence of a previous injury. The D'backs may shut him down ... Great idea, and not just for the play-in ...

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